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Living Our Values
It was another exceptional year within Provide Community, with much of our activity focused on supporting the continued national response to the COVID-19 pandemic, while at the same time working to deliver exceptional care every day.
Care and compassion are at the heart of our organisational Values, and we are proud of all our colleagues who bring these Values to life within our services, delivering Care with skill, respect, humanity and kindness at every opportunity.
Innovation is another core organisational value and the on-going pandemic encouraged us to think and work differently. By embracing the challenges before us we were able to work collectively to identify new ways of working, using technology to improve our efficiency and the quality of the care we deliver. The following examples show how we did this.
One of the key successes of the past year was the national COVID-19 vaccination programme which Provide Community colleagues stepped up to support by both delivering vaccinations to people and receiving the vaccine themselves. We redeployed our corporate clinicians to work in the local community vaccination centres delivering timely COVID-19 vaccines to the public. We also offered the COVID-19 vaccine to staff and 96% of our colleagues received the vaccine. By doing this our colleagues helped to protect the communities where we live and work.
Customer Engagement
Customer engagement is central to our everyday work and, in recognition of its importance, the MSE Community Collaborative (a partnership of the three community health care providers, Provide Community, North East London NHS Foundation Trust (NELFT) and Essex Partnership University NHS Foundation Trust (EPUT)) worked with Healthwatch Essex to develop an MSE Community Collaborative Patient Engagement Strategy. This new strategy outlines an agreed set of principles that now forms a framework for how we will work as a collaborative to be inclusive, giving the people who use our services the opportunity to engage with us to share their lived experience, to co-produce services when we redesign or review them and to ensure we understand and communicate with them in a way that meets their needs and preferences.
Within our supported living and residential care services for adults with learning disabilities, we developed information leaflets in easy read formats and now have an easy read leaflet on how residents or their families can give feedback about the services they use. Alongside this, we developed our Learning Disability Strategy and published this in an easy read format. We also introduced the Widgit App to support the development of information. The Widgit App is a set of clear and concise symbols that can be used to develop communication charts but can also combine text with symbols in documents to help people better understand the content. It was used successfully to translate the minutes of a residents’ meeting into a format that is more accessible as shown in the illustration included here:
Delivering effective Long COVID services
Clinical colleagues in our COPD service led the Mid and South Essex Long COVID Service made up of a multidisciplinary expert team working across mid and south Essex. This service was recognised as an exemplar in The NHS Plan for Improving Long COVID Services (NHS England July 2022 Publication approval reference: C1607).
The NHS Plan notes the pioneering use of a mobile clinic in a van to give residents in hard-to-reach areas access to high quality proactive and preventative care for post COVID syndrome and its symptoms. The outreach van goes to communities to offer health checks and diagnostic tests in this for adults, children and young people, including blood pressure, heart rate, oxygen saturation, spirometry, other tests for breathlessness, and 6-lead electrocardiography.
The Long COVID team worked with other local teams to provide information on smoking cessation, social prescribing and local facilities. People referred to the Long COVID clinic could book appointments to be seen in the van or people can walk in to talk to the team about Long COVID and its symptoms.
Meeting the needs of frail people at home
In response to national recommendations, Provide Community took a lead role with the MSE Community Collaborative facilitating the set-up of Virtual Hospital Wards, including the Frailty Virtual Wards. The aim of virtual wards is to provide safe clinical care to people in their own homes when they are unwell or have been unwell. By receiving timely assessment and care they can stay at home rather than be admitted to hospital, or they are able to leave hospital sooner, so they spend less time in a hospital bed. This service proved to be popular with the people who have used the Frailty Virtual Ward and an evaluation on outcomes has shown that people have increased their independence and have reduced functional decline. They also had fewer infections compared to people receiving equivalent treatment in a hospital setting.
The Frailty Virtual Ward is supported by Carecall24 7, utilising the care technology service, to provide telecare to enable proactive support plans to be initiated in response to trends and flags that indicate a pattern or change in health needs.
Embracing Innovation & Technology to Improve record-keeping
Good clinical record keeping and access to clinical records to support continuity of care is essential in the delivery of our services. To make electronic records more accessible and easier to complete, we introduced a range of new technologies in the community nursing service including:
New mobile phones with better functionality, better connectivity, and access to useful Apps. Brigid mobile phone App that enables easy access to our electronic patient record system, System 1. DragonOne software which enables direct dictation of clinical information into the electronic record. This improved the quality of the records and is faster which frees up staff time. Care Free Care Management System rolled out to Calvern Care to support effective rostering, invoicing and Care Management oversight. Birdie electronic care record introduced to the Calvern Care domiciliary care service allowing colleagues to record care given and raise concerns via an App on their mobile phone. Family members also have limited access to support effective communication.
We also invested time in reviewing care plans and templates to make record keeping easier and quicker.
Scheduling the right colleagues to deliver the right care at the right time
Our Community Nursing teams introduced Autoplanner software that matches and allocates appropriately skilled colleagues to undertake each clinical visit and ensures visits are allocated to reduce unnecessary travel, thus freeing up more time for visits and saving on travel costs. This new software also freed up senior clinicians within the service from administrative tasks associated with the allocation process and has enabled them to undertake more patient facing care.
In addition, the Carefree and Birdie Apps used in our Domicilliary Care services enable not just the skills but also the interests of the care colleagues to be matched to the needs and interests of the people who use the service.
Continuing to embed good practice in wound care
As part of the MSE Community Collaborative we worked in collaboration with NELFT and EPUT to share expertise and standardise and improve how we deliver wound care. As a result, we were chosen by the national team to be an accelerator site for early adoption and implementation of the National Wound Care Strategy. This benefitted us with more training that is building on our existing staff capabilities and improving clinical outcomes for people with lower leg wounds. As part of this work, we have agreed a joint dressings formulary to be used across mid and south Essex to ensure we have dressings available that are effective and cost-effective.
We also invested in new Doppler Ultrasound Equipment in the Tissue Viability service which has enabled us to assess leg circulation in more depth and patients no longer need to rest for 25 minutes before the scan can take place. It has also reduced the number of people having to be referred to hospital for further assessment.
A lot of work was undertaken during the year to reduce waiting times for people who use our services. We started the year with 21% of people waiting longer than 18 weeks for an assessment and ended the year with 15% waiting longer than 18 weeks. This represents a 6% improvement in position and we will continue to focus on reducing waiting times in the year ahead. We also had 245 people waiting longer than 52 weeks for assessment at the beginning of the year and at the end of the year this had been reduced to 36 people which is an improvement of 85%. This remains a key priority for the year ahead.
In the Community Paediatric Services across mid and south Essex, we have seen a considerable increase in the number of children and young people who have been referred for an Autism Spectrum Disorder (ASD) assessment. This meant that waiting times have increased as demand has far outweighed the capacity required to undertake these assessments. To address this, the commissioners provided funding to enable more children to be assessed. This enabled the waiting list size to be reduced and the waiting time decreased from 3 years to 48 weeks.
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valuing our colleagues
